Diabetes Risk Higher in Metabolically Healthy Obesity

Patients with metabolically healthy obesity are more likely to develop type 2 diabetes.

People with metabolically healthy obesity had a significantly increased risk for developing type 2 diabetes, particularly among those who became metabolically unhealthy over time, according to a study presented at ObesityWeek 2016.

“Obesity has been associated with diabetes,” the researchers wrote. “The aim of this study was to investigate the role of baseline adiposity and the effect of the change in metabolic status among participants with metabolically healthy obesity status on the future risk of diabetes onset.”

In the study, metabolic health­­—defined as having 1 or no risk factors according to the Adult Treatment Panel-III criteria—was assessed in 2756 participants. The hazard ratio (HR) of developing diabetes across changes in metabolic and adiposity status of metabolically healthy obese participants was estimated via Cox analysis.

After 27,727.6 person-years of follow-up, risk for becoming unhealthy was 44% higher among metabolically healthy obese participants vs lean or overweight healthy participants. As expected, the risk for developing diabetes was also increased among these participants, although this finding was primarily driven by those who progressed to an unhealthier status over time (HR: 4.78; 95% confidence interval [CI], 3.36-6.78).

Notably, the researchers found that the triglyceride-glucose (TyG) index was the strongest predictor of change in metabolic health status (area under the curve: 0.71; 95% CI, 0.68-0.74).

“Individuals with metabolically healthy obesity had an increased risk of incident type 2 diabetes but more specifically among those who progressed to global metabolically unhealthy status over time, rather than just weight gain,” the researchers concluded.